title: Longitudinal changes in left ventricular stiffness: a community-based study.
abstract: BACKGROUND
  Cross-sectional studies suggest that left ventricular (LV) and arterial elastance (stiffness) increase with age, but data examining longitudinal changes within human subjects are lacking. In addition, it remains unknown whether age-related LV stiffening is merely a reaction to arterial stiffening or caused by other processes.
  
  
  RESULTS
  Comprehensive echo-Doppler cardiography was performed in 1402 subjects participating in a randomly selected community-based study at 2 examinations separated by 4 years. From this population, 788 subjects had adequate paired data to determine LV end-systolic elastance (Ees), end-diastolic elastance (Eed), and effective arterial elastance. Throughout 4 years, blood pressure, arterial elastance, and LV mass decreased, coupled with significantly greater use of antihypertensive medications. However, despite reductions in arterial load, Ees increased by 14% (2.10±0.67-2.26±0.70 mm Hg/mL; P<0.0001) and Eed increased by 8% (0.13±0.03-0.14±0.04 mm Hg/mL; P<0.0001). Increases in Eed were greater in women than men, whereas Ees changes were similar. Age-related increases in Ees and Eed were correlated with changes in body weight, but were similar in subjects with or without cardiovascular disease. Changes in Ees were correlated with Eed (r=0.5; P<0.0001), but not with other measures of contractility, indicating that the increase in Ees was reflective of passive stiffening rather than enhanced systolic function.
  
  
  CONCLUSIONS
  Despite reductions in arterial load with medical therapy, LV systolic and diastolic stiffness increase over time in humans, particularly in women. In addition to blood pressure control, therapies targeting load-independent ventricular stiffening may be effective to treat and prevent age-associated cardiovascular diseases, such as heart failure.
authors.affiliation: Department of Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Borlaug
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Redfield
authors.forename: Vojtech
authors.initials: V
authors.lastname: Melenovsky
authors.forename: Garvan C
authors.initials: GC
authors.lastname: Kane
authors.forename: Barry L
authors.initials: BL
authors.lastname: Karon
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rodeheffer
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D004548:Elasticity; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009200:Myocardial Contraction / Q000187:drug effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000959:Antihypertensive Agents
keywords: aging; arterial stiffness; heart failure; hemodynamics; ventricular function